Contracted Services

Adoption Purchase of Services

• Contracted Out of State Health and Safety Report

Behavior Rehabilitation Services (BRS)

• Published Fee Table
• Behavior Management Guidelines
• Wraparound with Intensive Services (WISe)
  • WISe Information
  • WISe Referral Contacts
• BRS Annual Report - 2017-2018
• BRS Annual Report - 2006-2018
• BRS Monthly Census
• BRS Provider CFARS Scoring Tool

Child Placing Agency

• Published Fee Table
• Billing Form
• Licensed Home Incentive Billing Form

Combined In-Home Services

• Combined In-Home Services

Emergent Initial Family Time

• Published Fee Table
• Emergent Initial Billing Form Regions 3 & 4
• Emergent Initial Billing Form Regions 5 & 6

Emergent Placement Services

• Emergent Placement Service Child Transition Summary
• Billing Form
• Emergent Placement Services Fee Table

Extra 1-1 Supervision

• Extra 1-1 Supervision

Family Time/Sibling Visit Services

• Family Time/Sibling Visit Fee Schedule
• Pre-Service Training for Family Time/Sibling Visit Services Contracted Providers
• Family Time Visitation Location Resources
• Child Specific Caregiver Notification Report
• Unusual Incidents/Safety Concerns Report
• Family Time COVID-19 Guidance

Foster Parent Pre-Service Co-Trainer

• Published Fee Table

Health & Safety Visit Out of State

• Contracted Health and Safety Visit Referral
• Contracted Health and Safety Visit Report
• Billing Form

Independent Living

• IL Fee Table
• Casey Life Skills Assessment Tracking Report
• IL Data Log
• IL Blank Note Template
• IL Note Template
• IL Note Template Instructions
• ILS FamLink Documentation for Service Providers
• Documenting Highest Grade Completed for Service Providers
• Independent Living Referral
• Opioid Overdose Reversal Medications (Naloxone)
• Independent Living Learning Plan and Progress Report
• Casey Life Skills Assessment
• Chafee IL Youth Support Funds Guidelines

Indian Nation Child Placing Agency

• Indian Nation CPA Fee Table
• Licensed Home Incentive Billing Form

Medically Fragile

• Published Fee Table

Network Administration

• FIN72hour – listed at NA 72hr
• FIN Rate – listed as FIN Service Rate and Guidance
• Network Administrator Family Time Mid-Month Billing Form
• Network Administrator Monthly Anticipated Costs
• Network Administrator Quarterly Reconciliation

Nursing Services at DCYF Staffed Locations

• Billing Form

Professional Services

• Published Fee Tables
  • Region 1 & 2
  • Region 3 & 4
  • Region 5 & 6 
  • Substance Use Disorder (SUD) Assessment and Treatment Services
• Billing Form
• Parent Instruction Monthly Report
• Parent Instruction Exit Report
• Referral Form
• Evidence-Based Practice (EBP) Reporting Guide

Psychiatric Services

• Published Fee Table
• Billing Form
• Psychiatric Services Referral Form

Psychological Services

• Published Fee Table
• Billing Form
• Referral Form

Residential Substance Abuse Treatment Facility (SUD)

• Monthly SUD Roster and Invoice

Resource Assessment Center

• RAC Child Assessment Report

Respite Care and Foster Care Child Support Aide Services

• Published Fee Table
• Billing Form

Responsible Living Skills Program (RLSP)

• Published Fee Table

Sexually Aggressive Youth Treatment (SAY)

• Published Fee Table
• Billing Form

Short-term Case Aide Support Services

• Published Fee Table

Special CPA Group Receiving Care Services

• Special CPA Group Receiving Care Services Tier 2 Transition Summary